Correlation of Electroencephalography (EEG) Findings with Clinical Seizures in Children

Objective: To determine the sensitivity, specificity and diagnostic accuracy of electroencephalography in predicting the development of a second/recurrent seizures/epilepsy within one year of first attack, in children who have developed their first unprovoked seizure. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Paediatrics, Combined Military Hospital, Rawalpindi, Pakistan from Jan to Dec 2022. Methodology: This study was conducted on 126 paediatric patients who reported with a first unprovoked seizure. All patients aged between 4 and 12 years, of both genders. All participants underwent the recording of an EEG, for thirty minutes with photic and hyperventilation stimulation. All patients were followed-up for a period of one-year. Results:   Mean time from onset of seizure to presentation was 22.89±13.37 hours. An abnormal EEG was seen in 57(45.2%) patients: seizure activity was seen in 11(8.7%) cases, focal and generalized spike-waves in 11(8.7%) and 10(7.9%) cases, respectively, while slowing was seen in 31(24.6%) cases. Seizure recurrence was seen in 66(52.4%) cases. An abnormal EEG as a predictor for the development of recurrent seizures/epilepsy in children, who have had their first episode of unprovoked seizure, had a sensitivity of 57.58%, a specificity of 68.33%, a positive predictive value of 66.67%, a negative predictive value of 59.42% and a diagnostic accuracy of 62.70%. Conclusion: Electroencephalographic findings alone in paediatric patients suffering from their first unprovoked seizure carries inadequate sensitivity, specificity and diagnostic accuracy in predicting the development of future seizures.